Mesothelioma Diagnosis And What To ExpectMesothelioma Diagnosis And What To Expect

Diagnosis is a major issue in mesothelioma. Like all cancers, treatment is curative only in the early stages of the disease. Beyond a certain critical stage, treatment is only palliative. However, because of the rarity of mesothelioma, it is often wrongly diagnosed or diagnosed in its later stages.

Approximately all cases of mesothelioma have had previous exposure to asbestos. Hence a review of the history of the patient's exposure to asbestos is a major step towards the diagnosis of the disease. Under normal circumstances, a physician will never diagnose mesothelioma based only on the symptoms of the disease. This is because all the symptoms are non-specific, that is, they arise in several other health conditions, some of them being non-serious. Misdiagnosis is a serious impediment in mesothelioma treatment. It is the responsibility of the patient to disclose his past exposure to asbestos in order to achieve a speedy diagnosis.

In cases of pleural mesothelioma, the first diagnostic tool is generally the X-ray. This does not detect the tumors directly. Rather they detect pleural effusion (i.e. the accumulation of fluid between the lungs and the chest wall). Other indications of the disease are lung fissures, mineral deposits and thickening of the pleura. New imaging techniques like the CT Scan and the MRI are more efficient at determining the location, size and extent of mesothelioma tumors. MRIs give more or less accurate indication of how much the tumors have spread. Positron Emission Tomography (PET) is another new technique that uses cameras and tracers to identify biological changes and detect even very small cancerous tumors.

To confirm his diagnosis, the doctor may perform a test called thoracoscopy. This involves the insertion of an instrument called a thoracoscope into the chest wall (between two ribs), allowing the physician to see inside the chest cavity. In the case of peritoneal mesothelioma, a peritoneoscopy is done. This involves sending a peritoneoscope into an opening made in the abdomen under local anesthetic.

Any abnormal tissue found during these tests are sampled (a small piece is cut). The sample is observed under a microscope to detect the presence of cancer cells. This is called a biopsy and it is the only reliable diagnostic tool for mesothelioma. Biopsies can be of two types: open biopsy (performed under general anesthetic and using invasive surgery) and needle biopsy (using local anesthetic with minimal surgery).

If the presence of cancerous tissue in the lungs has been confirmed, it is important to distinguish between lung cancer and mesothelioma. This is done through the examination of the lymph nodes in a process called mediastinoscopy. This involves sending a lighted tube through the neck under the sternum and into the chest. The lymphatic system is crucial in the fight against infections and cancers. Examination of the lymph nodes reveals whether the cancer has progressed to the lymphatic system, in which case it is NOT mesothelioma.

The main difficulty in diagnosis of mesothelioma is the high latency between the contraction of the disease and the first symptoms. Most patients have been exposed to asbestos in their youth but the symptoms arise 30-40 years later.
by Jason Bacot
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